I smile at the excitement and tension as the students rustle with their gear. In a few hours they’ll find themselves coping with an injured patient in a dark, cold and remote environment. I’m pleased. It’s warm in the classroom while outside the temperature is well below freezing and the moon will not rise for hours. The students will manage with the gear they carry, make a decision to camp or attempt an evacuation, and perhaps improvise a shelter and build a fire in the cold and snow. These are NOLS semester students on their Wilderness First Responder course.

Wilderness medicine without wilderness skills, experience and leadership is an incomplete package. On many NOLS semesters it’s possible to combine our leadership and wilderness skills curriculum with a Wilderness First Aid (WFA) or Wilderness First Responder (WFR) certification. Semester students always return to tell me how valuable these skills have been in their lives — from responding to emergencies on personal trips, to administering first aid at the scene of a car accident, to practical experience for medical school.

The WFA and WFR cover wilderness medicine from airway to spine injury, asthma to pneumonia, altitude illness to snakebite. In addition to the standard “urban” curriculum, we address topics such as wound management and infection, realigning fractures and dislocations, improvised splinting techniques, patient monitoring and long term management problems, and up-to-date information on all environmental emergencies.

A WFA or WFR is a change of pace from a NOLS field experience. The courses are usually held 2 to 4 weeks into a semester in a classroom with access to outdoor practice areas. We go hard for 8 hours a day, moving quickly between lecture and scenario or practical sessions.

Semester graduates with the WFA or WFR credential are well prepared for jobs in the outdoors. The 24-hour WFA is approved by such organizations as the American Camping Association, the United States Forest Service, and other governmental agencies and is the minimum credential for many camps and field work positions. The 80-hour WFR is also the professional credential for NOLS Instructors, and many guides, outfitters and educators. Students that are looking for employment in outdoor education often choose the WFR semester. Not only do they have state-of-the-art medical instruction, but their field time builds their wilderness skills, experience and decision-making ability into the complete package.

One of the strengths of the WFR or WFA on a semester is that students continue the medical education and incorporate it into the field sections of the semester and their independent student travel. Continuing scenarios in actual field settings help to solidify the WFR and WFA skills.

Liz Touhy from the NOLS Rocky Mountain Program Department comments that “Knowing first aid information is great, but it’s only useful if you have the leadership skills to intervene when you see an accident, walk into a crowd of people, initiate the assessment process and start organizing unskilled people to help you.”

The WFR blends medicine with NOLS themes of leadership, teamwork and decision making. As this group gathers into their teams for the night rescue, I tell them to be observant, to gather information to make decisions, to communicate clearly and work together. I speak to our shared vision of safety for the rescuers, staying together and acting carefully. Then we venture into the snow and the dark – to have some fun and learn.